Of 86 patients with herpes zoster ophthalmicus seen at the Mayo Clinic, Rochester, Minn, from 1975 to 1980, 61 had some form of ocular involvement. Corneal disease was seen in 47, uveitis in 37, postherpetic neuralgia in 15, scleritis in three, and ocular motor palsies in three. No case of optic nerve or retinal involvement was found. Of serious concern were four patients with neurologic complications, including two with contralateral hemiplegia and two with segmental cerebral arteritis. Because the neurologic complications occur several months after the episode of herpes zoster ophthalmicus, the association is often overlooked and the opportunity to treat with corticosteroids for systemic effect is missed.